ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ CỦA PHƯƠNG PHÁP DẪN LƯU NÃO THẤT MỞ Ở BỆNH NHÂN CHẢY MÁU NÃO CÓ TRÀN MÁU NÃO THẤT

Abstract

Objective: To evaluate the treatment outcomes of patients with intracerebral hemorrhage and acute intraventricular hemorrhage (IVH) using external ventricular drainage (EVD) and to analyze some related factors. Subjects: A total of 66 patients with intracerebral hemorrhage who met the criteria for emergency intervention and were treated at the Stroke Department of 108 Military Central Hospital from January 2022 to April 2024. Methods: Interventional, prospective, longitudinal follow-up study without control groups. Results: Six months after discharge, 22.7% of the patients achieved good recovery outcomes (mRS 0–3). The main complications included pneumonia (36.4%) and chronic ventricular dilation (43.9%). The recurrence rate of intracerebral hemorrhage was 3%, and no patients who received intraventricular fibrinolysis experienced recurrent bleeding. Preoperative Glasgow Coma Scale (GCS) and NIHSS scores showed statistically significant differences between the groups with mRS scores of 0–3 and 4–6 after 6 months (p < 0.05). Specifically, a GCS score ≤ 8 and NIHSS score ≥ 22 were predictive of poor prognosis (mRS 4–6) after 6 months. Other factors, such as Graeb score, ICH score, IVH score, and hematoma volume, did not show significant differences between the two groups.

Conclusion: Patients with intracerebral hemorrhage and acute ventricular dilation have poor recovery prognoses, posing significant burdens on both the patients and their families. External ventricular drainage, with or without intraventricular fibrinolysis, is an effective method to improve outcomes for these patients.

Keywords: Intracerebral hemorrhage with intraventricular hemorrhage, external ventricular drainage, prognostic factors.